AB1271 FACTORS ASSOCIATED TO FRAGILITY FRACTURES IN RA PATIENTS: IS URIC ACID INCRIMINATED?
Authors: B. Touil, N. Akasbi, I. El Mezouar, T. Harzy
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Rheumatoid arthritis (RA) has been reported to be associated with low bone mineral density (BMD) and increased risk of fractures. Recently, several observational studies have revealed that a higher serum uric acid level was associated with higher bone mineral density (BMD), and therefore, a reduced risk of osteoporosis and fragility fractures in men, post- and perimenopausal women. Although the relationship between serum UA levels and BMD has been evaluated in the general population, data regarding the effect of UA levels on bone loss in patients with RA was lack [1]. <h3>Objectives</h3> To evaluate the relationship between UA levels, BMD and fragility fractures (FF) and the different factors associated with the occurrence of FF in RA patients. <h3>Methods</h3> We conducted a cross-sectional study in a single rheumatology hospital in Morocco. All patients satisfied the ACR-EULAR 2010 RA classification criteria. All the patients underwent BMD examination by dual energy x-ray absorptiometry and serum UA levels measurement. Osteoporosis was diagnosed when the T-score was - 2.5 or less. Socio-demographic data, comorbidities, disease-related variables (duration, characteristics, and drugs) were also collected. Statistical analysis were performed with SPSS 22. <h3>Results</h3> We included 88 (85.44%) women and 15 (14.56%) men with a mean age of 52.59 ± 14.77 years old. They had a mean disease duration of 14.27±10.84 years, a mean DAS 28 CRP of 2.59 ±1.35. Their mean lumbar spine, femoral neck and total proximal femur were 0.843 ± 0.134, 0.694 ± 0.111, and 0.826 ± 0.119 respectively. The UA levels were elevated in 10.8 % of patients, dyslipidemia was found in 19.3 % of patients and 38.9 % of the patients had osteoporosis. There was no correlation between UA concentrations and BMD, whether at the lumbar spine femoral neck and total proximal femur, and UA and fragility fractures. However, the occurrence of fragility fractures was significantly associated to BMD at the femoral neck (0.606 ± 0.126 vs 0.705 ± 0.104; p=0.027), to high concentrations of LDLc (3.69 ± 0.38 vs 2.71 ± 0.77 mmol/L; p=0.004), Total cholesterol (5.84 ± 0.74 vs 4.55 ± 0.85 mmol/L; p=0.001), ACPA antibodies titres (364.25 ± 101.35. vs 167.96 ± 120.30; p=0.047), cumulative corticosteroid dose (11057.64 ± 4653.35 vs 1330.20 ± 211.80 mg; p=0.008), to BMI (22.41 ± 4.41 vs 27.24 ± 4.94; p=0.018) and to the glomerular filtration rate (87.43 ± 12.11 vs 103.50 ± 15.38; p=0.018). <h3>Conclusion</h3> Although there was no relation between UA levels, BMD and FF in our population. FF were related to ACPA antibodies, BMD, kidney fonction and corticosteroid use. <h3>Reference</h3> [1]Lee HN, Kim A, Kim Y, Kim GT, Sohn DH, Lee SG. Higher serum uric acid levels are associated with reduced risk of hip osteoporosis in postmenopausal women with rheumatoid arthritis. Medicine (Baltimore). 2020 Jun 12;99(24):e20633. doi: 10.1097/MD.0000000000020633. PMID: 32541502; PMCID: PMC7302629. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.